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The Causes of the Exalto-Mann-Williamson Ulcer

The Causes of the Exalto-Mann-Williamson Ulcer Abstract THE DISCOVERY by Mann and Williamson1 in 1923 that diversion of the alkaline secretions of the duodenum into the lower ileum regularly caused the development of chronic, progressive peptic ulcers in dogs, stimulated an extensive experimental study of peptic ulcer disease. Exalto2 was actually the first to produce experimental ulcers by this method but his papers unfortunately failed to find a receptive audience. Both Exalto and Mann attributed the ulcers they produced to the corrosive digestant effect of the pepsin-hydrochloric acid of the gastric content coming into contact with the jejunal mucosa when not protected by the local neutralizing and buffering action of the pancreatic juice, bile, and succus entericus. Mann was led to modify this view somewhat when his associate McCann3 found that ulcers still developed after the Mann-Williamson procedure even though the duodenal secretions were shunted back into the stomach instead of into the ileum. References 1. Mann, F.C., and Williamson, C.S.: The Experimental Production of Peptic Ulcer , Ann Surg 77: 409, 1923.Crossref 2. Exalto, J.: Ulcus jejuni nach Gastroenterostomie , Mitt Grenzgeb Med Chir 23:13-41, 1911 3. Nederl Tijdschr Geneesk 5:469-481, 1911. 4. McCann, J.C.: Experimental Peptic Ulcer , Arch Surg 19:600-659 ( (Oct) ) 1929.Crossref 5. Matthews, W.B., and Dragstedt, L.R.: The Etiology of Gastric and Duodenal Ulcer: Experimental Studies , Surg Gynec Obstet 15:265, 1932. 6. Hay, L.J., et al: Experimental Production of Gastric and Duodenal Ulcers in Laboratory Animals by Intramuscular Injection of Histamine in Beeswax , Surg Gynec Obstet 75:170, 1942. 7. Storer, E.H., et al: Effect of the Exalto-Mann-Williamson Procedure on Gastric Secretion , Arch Surg 64:192-199 ( (Feb) ) 1952.Crossref 8. Baugh, C.M., et al: The Pathogenesis of the Exalto-Mann-Williamson Ulcer: II. Relation of the Antrum to the Hypersecretion of Gastric Juice in Mann-Williamson Animals , Gastroenterology 39:330, 1960. 9. Nagano, K., et al: The Pathogenesis of the Exalto-Mann-Williamson Ulcer: I. The Significance of the Neutralizing and Buffering Effect of the Duodenal Secretions , Gastroenterology 39:319, 1960. 10. Konturek, S., and Grossman, M.I.: Localization of the Mechanism for Inhibition of Gastric Secretion by Acid in the Intestine , Gastroenterology 49:74, 1965. 11. Greenlee, H.B., et al: Inhibitory Effect of Pancreatic Secretion on Gastric Secretion , Amer J Physiol 190:396, 1957. 12. Jordan, P.H., Jr., and de la Rosa, C.: Inhibition of Gastric Secretion by Duodenal Mucosal Extracts , Ann Surg 160:978, 1964.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1966 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1966.01330030122025
Publisher site
See Article on Publisher Site

Abstract

Abstract THE DISCOVERY by Mann and Williamson1 in 1923 that diversion of the alkaline secretions of the duodenum into the lower ileum regularly caused the development of chronic, progressive peptic ulcers in dogs, stimulated an extensive experimental study of peptic ulcer disease. Exalto2 was actually the first to produce experimental ulcers by this method but his papers unfortunately failed to find a receptive audience. Both Exalto and Mann attributed the ulcers they produced to the corrosive digestant effect of the pepsin-hydrochloric acid of the gastric content coming into contact with the jejunal mucosa when not protected by the local neutralizing and buffering action of the pancreatic juice, bile, and succus entericus. Mann was led to modify this view somewhat when his associate McCann3 found that ulcers still developed after the Mann-Williamson procedure even though the duodenal secretions were shunted back into the stomach instead of into the ileum. References 1. Mann, F.C., and Williamson, C.S.: The Experimental Production of Peptic Ulcer , Ann Surg 77: 409, 1923.Crossref 2. Exalto, J.: Ulcus jejuni nach Gastroenterostomie , Mitt Grenzgeb Med Chir 23:13-41, 1911 3. Nederl Tijdschr Geneesk 5:469-481, 1911. 4. McCann, J.C.: Experimental Peptic Ulcer , Arch Surg 19:600-659 ( (Oct) ) 1929.Crossref 5. Matthews, W.B., and Dragstedt, L.R.: The Etiology of Gastric and Duodenal Ulcer: Experimental Studies , Surg Gynec Obstet 15:265, 1932. 6. Hay, L.J., et al: Experimental Production of Gastric and Duodenal Ulcers in Laboratory Animals by Intramuscular Injection of Histamine in Beeswax , Surg Gynec Obstet 75:170, 1942. 7. Storer, E.H., et al: Effect of the Exalto-Mann-Williamson Procedure on Gastric Secretion , Arch Surg 64:192-199 ( (Feb) ) 1952.Crossref 8. Baugh, C.M., et al: The Pathogenesis of the Exalto-Mann-Williamson Ulcer: II. Relation of the Antrum to the Hypersecretion of Gastric Juice in Mann-Williamson Animals , Gastroenterology 39:330, 1960. 9. Nagano, K., et al: The Pathogenesis of the Exalto-Mann-Williamson Ulcer: I. The Significance of the Neutralizing and Buffering Effect of the Duodenal Secretions , Gastroenterology 39:319, 1960. 10. Konturek, S., and Grossman, M.I.: Localization of the Mechanism for Inhibition of Gastric Secretion by Acid in the Intestine , Gastroenterology 49:74, 1965. 11. Greenlee, H.B., et al: Inhibitory Effect of Pancreatic Secretion on Gastric Secretion , Amer J Physiol 190:396, 1957. 12. Jordan, P.H., Jr., and de la Rosa, C.: Inhibition of Gastric Secretion by Duodenal Mucosal Extracts , Ann Surg 160:978, 1964.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Sep 1, 1966

References